帕金森病患者行脑深部电刺激手术的麻醉管理:基于国内多中心的横断面调查

Anesthesia management of deep brain stimulation implantation for Parkinson's disease:a multi‑center cross‑sectional survey based on medical institutions in China

目的调查国内帕金森病患者行脑深部电刺激(deep brain stimulation,DBS)手术的麻醉管理现状,进而为优化DBS手术麻醉策略、改善患者预后提供参考。方法利用问卷制作软件设计线上问卷调查表,设置医院名称、性质,开展DBS手术时间和数量,不同手术阶段的麻醉方式、药物选择和气道管理,术后谵妄和苏醒延迟发生率等38道题目,并对回收的调查表进行描述性统计分析。结果共回收来自全国36家三级医院的有效问卷59份。目前国内开展DBS手术的医院分布并不均衡,虽然很多医院开展DBS手术时间超过5年,但医院每年开展DBS手术的数量差异很大,该手术麻醉管理策略方面各医院存在明显差异。结论调查初步反映了国内DBS手术麻醉管理存在较大改进空间,麻醉医师应当了解帕金森病患者的病情特点和DBS手术麻醉管理的特殊需求,未来有必要加强国内医院间合作,开展多中心临床研究,提高循证医学质量。

Objective To investigate the current status of anesthesia management of deep brain stimulation(DBS)implantation for patients with Parkinson's disease in China,which can provide a reference for optimizing the anesthesia strategy of DBS and improving the prognosis of patients.Methods An online questionnaire was designed utilizing questionnaire‑making software.The questionnaire contained 38 items,including the hospital's name and characteristics,the number of DBS operations,anesthesia methods at different surgical stages,drug selection and airway management,the incidence of postoperative delirium and delayed recovery,etc.Descriptive statistical analysis was conducted on the recovered questionnaires.Results A total of 59 questionnaires were collected from 36 tertiary hospitals.At present,the distribution of DBS surgery in our country is uneven.Although many hospitals have performed DBS surgery for more than five years,the number of DBS surgery in different hospitals varies greatly each year.There was also significant diversity in anesthesia management strategies for DBS surgery among medical centers.Conclusions This survey preliminarily reflects the current situation of anesthesia management in DBS surgery in China.Anesthesiologists should understand the characteristics of Parkinson's disease and the particularity of DBS surgery anesthesia management.It is necessary to strengthen the training and academic exchange regarding anesthesia management strategies,promote multicenter collaboration,and develop clinical trials to improve the quality of evidence‑based medicine.